What are the brown patches on this woman's cheeks?
33 year old Asian woman with brown patches on both cheeks, developed around the time she had her second child.
What is your diagnosis?
A 20-year-old woman presents to the clinic for evaluation and treatment recommendations for brown patches appearing on both cheeks. The patient reports development of brown patches on both cheeks over the last 12 months. She has a history of oral contraceptive use but only for two weeks approximately 18 months ago.
Acquired bilateral nevus of Ota, also known as Hori’s nevus.
This condition is quite commonly mistaken for melasma. I have seen many patients who have used both over-the-counter bleaching agents and prescription bleaching agents to treat melasma without any results. Because of its location, timing of onset (late teens, early 20s), it is understandable why many mistake this for melasma. Topical lightening agents that contain hydroquinone rarely if ever treat this condition satisfactorily. The best approaches are using laser surgical approaches, as mentioned in the articles below.
Take-home point: Any time you’re thinking melasma, especially in an Asian female with development patches in late teens or early 20s, always keep in mind the acquired bilateral nevus of Ota, also known as Hori’s nevus.
Charles E. Crutchfield III, MD
Clinical Adjunct Associate Professor of Dermatology
University of Minnesota Medical School
Medical Director, Crutchfield Dermatology